Manage The Hurt

By Linda Pescatore

By any measure, it was stressful to be Matt Saathoff in July 2008. The 31-year-old Omaha, Neb., banker and law student and his wife, Cat, had their first child, son Jamison, one month previously.

Work, school, family -- it would be stressful for anyone. But Saathoff did it all while suffering constant pain from a car accident two years earlier.

"I forced myself never to miss school, never to miss work, so I just burned myself out," Saathoff said. "I'd come home and I'd pretty much just have to sit on the couch and do nothing."

According to the American Pain Foundation, 50 million Americans experience chronic pain that interferes with their daily activities. Chronic pain is defined as any pain that lasts six months or more; it can come and go, or it can be constant.

With a herniated disc, splintered vertebrae and damage to a cervical nerve root, Saathoff was taking strong painkillers that made studying difficult. It was hard to sit for extended periods.

The pain and discomfort affected his marriage. He later learned his wife was "at her wits' end" because he was miserable all the time, he said.

But just a month later, Saathoff had his life -- and his wife -- back. "As Cat describes it, I'm a 180 percent different person," he said. "You don't hardly recognize the Matt of early July compared to the Matt of late August."

There was, however, no miracle cure. In fact, Saathoff's pain is unchanged. The difference is that he underwent a comprehensive four-week pain management program at The Nebraska Medical Center, where he learned to enjoy life again and end his physical dependency on drugs.

While opioid drugs such as Oxycodone, which Saathoff was taking, have their place in treating acute pain, they can make matters worse for the chronic pain patient, according to Dr. Barry Cole, executive director of the American Society of Pain Educators.

"We're beginning to think that opioids for some people cause their nervous system to eventually misprocess pain," Cole said. "The more opioids they take, they're getting worse and worse, not better and better."

Comprehensive care teaches patients to cope "without having to rely on something given to you -- that you reach inward instead of outward," Cole said.

"We have to treat the whole person; it's not just a neck, a shoulder, a head, a toe," said Dr. Jim Willcockson, manager of the Nebraska program. With this philosophy, he even requires spouses and family to participate.

His program's psychologists, physical therapists and nurses help a maximum of six patients address the physical, mental and emotional aspects of pain. Massage and stretching loosen and lengthen muscles. Cognitive behavioral therapy helps patients to manage their daily exertion, teaching them to pace themselves. With self-hypnosis and visual imagery, patients put mind over matter.

Saathoff was skeptical that he could function without painkillers. "You're on these drugs, and the drugs aren't even helping," he said. "How is using your mind and getting active going to actually work?"

Despite his initial skepticism, Saathoff "was great with visualization," Willcockson said. Because Saathoff described his shoulder pain as burning, while hypnotized he was guided to imagine the pain as hot as the sun, then it would change to a jet engine, to a blowtorch, to a Bunsen burner, to a candle, to a match.

"By the time it was a match in his mind, he reaches up and wets his fingertips and then makes a 'sss' sound, and he basically extinguishes his pain," Willcockson said.

"It's so hard to describe," Saathoff said. "The pain is there, but it's not at the front of my head. It's at the back of my head."

Another patient eliminated her pain solely through her guided imagery, although she needs periodic "booster shots," Willcockson said.

Although the Nebraska program is new, similar pain management programs abounded in the 1980s, said Cole. At their peak, there were about 3,000 in the U.S., but it's believed they're down to 300. Cole blames managed care.

"It was more cost-effective to drug people or stick needles into people than it was to provide comprehensive care, even though if you looked at the numbers, comprehensive care in the long run was cheaper and actually was proven to be more effective," Cole said.

Mere weeks after finishing the program, Saathoff is a new man. No longer collapsing on the couch, he's learned to take smaller bites of exertion -- mowing the lawn in thirds, for example -- and has even revisited sports such as table tennis, which he played competitively before his injuries.

"I'm nowhere near the level I was before the accident, but I've been playing one night a week for about two hours, which is way more than I ever expected," he said.

To find a treatment center for chronic pain, go to nationalpainfoundation.org/MyProviders/default_search.asp